Pfafferott C, Moessmer G, Ehrly A M, Bauersachs R M
I. Medical Department, City Hospital, Ingolstadt, Germany.
Clin Hemorheol Microcirc. 1999;21(1):35-43.
The objective of the study was to identify the relative importance of erythrocyte flow resistance and aggregation in acute and chronic coronary syndromes. 117 subjects in five groups were studied: (1) 34 patients shortly after acute myocardial infarction (AMI) before reperfusion therapy; (2) 27 patients with unstable and (3) 21 with stable angina pectoris (AP); (4) 14 age-matched control patients and (5) 21 healthy volunteers. Single erythrocyte transit times were measured using the Cell Transit Analyser. Shear dependent elongation and aggregation was measured by a modified computerized Myrenne aggregometer. Leukocyte count was increased in coronary artery disease (CAD), especially in acute syndromes (mean +/- SD for groups 1-5): 12.2 +/- 4.5; 10.0 +/- 5.4; 8.0 +/- 2.0; 8.0 +/- 3.7; 7.0 +/- 2.0 (pl(-1))). Platelets, hematocrit, fibrinogen, alpha2-macroglobulin did not differ between the groups. Plasma viscosity (mPas) was elevated in AMI and stable AP: 1.34 +/- 0.10; 1.30 +/- 0.09; 1.32 +/- 0.08; 1.27 +/- 0.07; 1.27 +/- 0.05. Erythrocyte filtrability was not different as was the shear dependent deformation. Aggregation parameters such as gammaTmin were elevated in CAD: 180 +/- 70; 159 +/- 60; 166 +/- 59; 115 +/- 43; 113 +/- 51 (s(-1)). Erythrocyte deformability, measured with two independent methods, does not appear to contribute to the pathophysiology of acute coronary syndromes. Erythrocyte aggregation and plasma viscosity were again found increased both in unstable and stable coronary disease. It is unlikely that increased red cell aggregation contributes to emergence of AMI.
该研究的目的是确定红细胞流动阻力和聚集在急性和慢性冠状动脉综合征中的相对重要性。对五组中的117名受试者进行了研究：（1）34例急性心肌梗死（AMI）后不久、未进行再灌注治疗的患者；（2）27例不稳定型和（3）21例稳定型心绞痛（AP）患者；（4）14例年龄匹配的对照患者和（5）21名健康志愿者。使用细胞转运分析仪测量单个红细胞的通过时间。通过改良的计算机化Myrenne聚集仪测量剪切依赖性伸长和聚集。冠状动脉疾病（CAD）患者的白细胞计数增加，尤其是在急性综合征中（第1 - 5组的平均值±标准差）：12.2±4.5；10.0±5.4；8.0±2.0；8.0±3.7；7.0±2.0（×10⁹/L）。各组之间的血小板、血细胞比容、纤维蛋白原、α2 - 巨球蛋白无差异。急性心肌梗死和稳定型心绞痛患者的血浆粘度（mPas）升高：1.34±0.10；1.30±0.09；1.32±0.08；1.27±0.07；1.27±0.05。红细胞过滤性以及剪切依赖性变形无差异。CAD患者的聚集参数如γTmin升高：180±70；159±60；166±59；115±43；113±51（s⁻¹）。用两种独立方法测量的红细胞变形性似乎对急性冠状动脉综合征的病理生理学没有影响。再次发现不稳定型和稳定型冠状动脉疾病患者的红细胞聚集和血浆粘度均升高。红细胞聚集增加不太可能导致急性心肌梗死的发生。
